Arthroscopy: The Journal of Arthroscopic & Related Surgery
Accuracy of anterior intra-articular injection of the glenohumeral joint
Section snippets
Methods
Forty-one patients scheduled for magnetic resonance imaging (MRI) arthrography were identified for the study. The patients all had the presumed diagnosis of rotator cuff tear or labral tear and were accordingly scheduled for MRI arthrography. Patients were studied consecutively. Body-mass index or habitus were not recorded. There were no exclusion criteria.
A single examiner performed all of the injections (S.K.); the single operator was well versed in anatomy and he performs hundreds of
Results
There were 31 male and 10 female patients. The average age was 45 years (range, 17 to 77 years). The patients diagnoses (after MRI) were rotator cuff tear in 11, superior labral tear in 8, partial rotator cuff tear in 4, osteoarthritis in 1, and normal for the remaining 12 subjects. No patients had undergone any previous surgery.
Of the injections placed anteriorly, 26.8% (11 of 41) were actually intra-articular. The remaining were extra-articular, the most common location of error being either
Discussion
The accurate placement of intra-articular injections may be taken for granted. Inaccurately placed injections will limit the diagnostic yield of the injection. Similarly, inaccurate injection will limit the therapeutic yield of the injection.2 Furthermore, misplaced steroid may damage tendons such as the rotator cuff.4 Therefore, it is very useful to know the likelihood of accurate injection placement. Our unpublished data suggested that an anterior injection would be accurate 80% of the time
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